Health: Contraceptive Services

Lord Watts Excerpts

Thursday 11th October 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Baroness is quite right that there is an obligation in the GP contract. We are in the process of renegotiating the contract for the next financial year, and I shall certainly take that issue back and feed it in to the team that is carrying out the negotiation.

[Lord Watts (Lab)]

My Lords, now that austerity is over, when will local government budgets be restored so that local authorities can address issues such as the one we are hearing about today?

[Lord O’Shaughnessy]

Local authority budgets will of course be a matter for the spending review that will take place at some point during the next year.

General Practitioners: Indemnity Scheme

Lord Watts Excerpts

Monday 16th July 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord is right to highlight this issue. It is important to state that the rising cost of indemnity is not driven by a poor or worsening safety record but by the volume of activity and the rising cost of the average claim. Not only do we need to make sure that we reduce those costs, for example, by introducing a fixed recoverable cost scheme, we also need to reduce the number of safety issues so that there are fewer claims to bring in the first place.

[Lord Watts (Lab)]

My Lords, is it not the case that the costs are rising because GPs do not have sufficient time to see their patients? It is all linked to the shortage of GPs, which means that they have to see more patients for shorter periods.

[Lord O’Shaughnessy]

No, it is not.

Prescription Drugs: Dependence

Lord Watts Excerpts

Monday 19th March 2018 Lords Chamber

[Lord O'Shaughnessy]

I would definitely be straying into Home Office territory by commenting on that. I would point out that cannabis remains illegal in this country and that the PHE review’s scope is to work within the drug strategy set out by the Home Office.

[Lord Watts (Lab)]

My Lords, does the shortage of mental health services in the NHS and the cuts to local authorities not mean that GPs often have no alternative but to prescribe drugs? Should the Government not address the shortages in both those areas?

National Child Obesity Strategy

Lord Watts Excerpts

Monday 26th February 2018 Lords Chamber

[Lord O’Shaughnessy]

I thank my noble friend for that and applaud the work that she has done in this area. The Amsterdam effect seems significant and is an area we are looking at as we consider further actions in future.

[Lord Watts (Lab)]

Does the Minister agree that it would be a good idea to reintroduce domestic science into all schools so that people have a better mechanism for preparing and eating more quality foods than fast foods?

[Lord O’Shaughnessy]

I reassure the noble Lord that the national curriculum, through PSHE, includes elements around nutrition and healthy eating. Indeed, many schools offer the kind of classes he is talking about.

NHS: Nurse Retention

Lord Watts Excerpts

Wednesday 17th January 2018 Lords Chamber

[Lord O’Shaughnessy]

In the last few years there has been an increase in agency spend. Of course, per nursing hour that tends to be more expensive. We have managed to reduce agency spend by increasing the availability of nursing banks. Those are the people employed on flexible contracts, which is very welcome for many nurses who are looking for—as they say in staff surveys—greater flexible working arrangements.

[Lord Watts (Lab)]

My Lords, how did the Government get their planning so wrong? The demographics were known, and yet the Government have failed to plan to provide the sorts of numbers of nurses that we need. What went wrong?

[Lord O’Shaughnessy]

We know that we have a growing ageing population—I do not doubt that. We have been increasing real-terms funding for the NHS, which is going on more staff. Nurse numbers have increased and I should point out that there are more doctors and ambulance staff. There have been about 40,000 more clinical staff in general in the NHS over the past few years and more to come in the future.

Nurses and Midwives: Numbers

Lord Watts Excerpts

Monday 4th December 2017 Lords Chamber

[Lord Watts (Lab)]

My Lords, given the shortage of medical staff right across the board, should not the Government exempt them from quotas so that we can guarantee that we will have the medical staff and support staff that we need in our hospitals?

[Lord O'Shaughnessy]

In the long run, we want to be in a position to provide more of our staff domestically. There are concerns about the fact that we recruit from other countries, not least developing countries—I do not think that that is a long-term, sustainable position. In addition to the additional nurse training places that I mentioned, more medical training places for doctors are coming through, so we will be achieving that position in future.

Mental Health Care: Vulnerable Children

Lord Watts Excerpts

Tuesday 28th November 2017 Lords Chamber

[Lord O'Shaughnessy]

The right reverend Prelate is quite right: there is stigma attached. There have been a number of important initiatives, not least from His Royal Highness Prince Harry—who I am sure we all want to congratulate on his recent engagement—to reduce stigma and to demonstrate that mental health problems can, unfortunately, strike anyone of any positional station in society at any time in their life. Making that admission is the first step to seeking help.

[Lord Watts (Lab)]

My Lords, what are the Government doing to make sure that health trusts spend the resources available on this area of work? The facilities that these children are being seen in is appalling in some cases. What are the Government going to do about both of those issues?

[Lord O'Shaughnessy]

I can reassure the noble Lord that spending on children and young people’s mental health by CCGs, which are responsible for commissioning those services, increased by 20% between 2014-15 and 2015-16, so spending is increasing. Clearly, one of the areas in which that money is being spent is on better facilities. One of the additional changes is that about 150 new beds will be commissioned in underserved areas so that we can reduce the number of out-of-area placements, which can be quite disturbing for some of the children and young people who have to use them.

Social Care in England: Older People

Lord Watts Excerpts

Monday 20th March 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right that there is a growing need for care for older people because of our ageing and growing population. I am sure she welcomes the additional funding announced in the Budget. It brings to over £9 billion the additional funding announced since 2015 for social care for the next three years, and that will make a big difference to meeting the kinds of care needs that she is talking about. She talked about the difference between the short term and the long term. That is why the other crucial part of the Budget announcement concerned the Green Paper. This will be ambitious in scope, with the intention of creating a fairer and more sustainable system of the kind I am sure she wants to see.

[Lord Watts (Lab)]

My Lords, does the Minister agree that the Government’s decision to cut spending to local authorities’ care services has created this crisis?

[Lord O'Shaughnessy]

Much more funding is now going into the social care system to reflect the additional needs of the ageing population. I am looking forwards in thinking about the extra £9 billion that will be provided. We also have over 150,000 more care workers helping people in the system, whether in residential care homes and nursing homes or at home through domiciliary care.

Mental Health: Children’s Services

Lord Watts Excerpts

Thursday 19th January 2017 Lords Chamber

[Lord O'Shaughnessy]

I could not agree more with those points, in the sense that money must get through to the front line. However, we have an NHS that is set up so that clinical decisions are made by clinicians rather than politicians, and that must be right, because the needs vary from area to area and different areas have different priorities. They have different historic legacies in terms of delivering their services. As for the direction that we give to schools and colleges, clearly the thematic review that the CQC and Ofsted are carrying out will provide advice on what works. We are also introducing some randomised control trials to look at interventions that work, so we have a proper evidence-based system. The commitment is to get 70,000 more young people having evidence-based treatments by 2021.

[Lord Watts (Lab)]

My Lords, is it not clear that the present system of “hands off” is not working? People working in this service are desperate to make sure that the Government take action to ring-fence this funding so that vulnerable children are not put at risk.

Young People: Self-Harm

Lord Watts Excerpts

Tuesday 6th December 2016 Lords Chamber

[Lord Prior of Brampton]

I think the right reverend Prelate has raised an incredibly important issue. Around 300,000 young people go to A&E every year through self-harm, after cutting or burning themselves very badly. The right reverend Prelate asked about advice and guidance. In 2004, NICE put out explicit guidance that all those people should receive, at the very least, a psychosocial assessment; today, only 53% of those people—young people in the main—receive such an assessment. That means that 100,000-plus people are going to A&E with this very nasty self-harm and are really being sent home with very little. That is quite an indictment of our system and the words that we have about parity of esteem. I entirely take on board exactly what the right reverend Prelate said. There is a lot more we can do, and perhaps in response to subsequent questions I shall try to say what we are doing.

[Lord Watts (Lab)]

The Minister will know that the mental health service is in crisis. He says on a regular basis that the Government are putting more resources into the area of mental health for young people. He also knows that that money is not getting spent by the trusts. When is he going to sack the trusts, or sack the chief executives of the trusts, for failing to spend that money on vital services for young people?

[Lord Prior of Brampton]

Last year, the rate of spend by CCGs on mental health went up by 8.6%, compared to 3.7% across the board, so the money is starting to get through. The fact is, though, that there are nooks and crannies in our NHS—which we all love—where we have fundamentally let people down for many years. The issue of self-harm and the suicide risk that derives from self-harm is a very black hole at the heart of the NHS.